Professor Adam R Winstock, founder & CEO GDS, Consultant Psychiatrist and Addiction Medicine Specialist, says:

OK there is no such thing. If your pill has MDMA in it and you know how much MDMA in mg it contains – there’s probably not much else you need, assuming you follow all the sensible strategies that allow you to reduce your risk of harm as much as possible. Even if you do everything and know what’s in your pill, you still not cannot guarantee a fun or safe time but it would help loads and loads. But accepting the ‘chemical’ and its ‘dose’ are fundamental to influencing your drug experience and that most people don’t know for sure the composition of a new MDMA pill the first time they take it; wouldn’t it be nice if they did.

Common place since 2015, high dose MDMA surfaced as a way of cementing a new supplier's product credentials, raising brand awareness, if you will, and adding the growing confidence that after five or six years of pretty rubbish product, ecstasy was a drug that you could have high hopes of. Accompanied by the widespread distribution of MDMA powder (just crushed crystal), increases in quality and availability were matched by increases in price, rates of use, diversity of innovative logo branding (including random shapes, fluorescent pills and multi-coloured tablets) acute harms and deaths. While escalating price and sales are good for profit, the rise in harms was not good. MDMA was getting lots of bad PR. Combined with the odd appearance and tragic deaths associated with pills containing PMMA, one positive consequence may have been renewed focus on harm reduction including the re-invention and modern re-interpretation of pill testing. Overall however, I don’t think high dose pills were a good thing for anyone.